作者: Ola G. Nilsson , Lennart Brandt , Urban Ungerstedt , Hans Säveland
DOI: 10.1097/00006123-199911000-00032
关键词: Neurology 、 Brain ischemia 、 Ischemia 、 Transcranial Doppler 、 Medicine 、 Anesthesia 、 Vasospasm 、 Intensive care 、 Subarachnoid hemorrhage 、 Microdialysis
摘要: OBJECTIVE: Intracerebral microdialysis has been demonstrated to be a useful method for detection of brain ischemia in experimental models and patients. We have applied new mobile microdialysate analysis equipment that allows bedside comparison changes neurochemistry with the neurological status patient. Ten patients severe aneurysmal subarachnoid hemorrhage (that is, high risk vasospasm subsequent ischemic deficits) were selected.METHODS: Microdialysis catheters inserted into temporal subfrontal cortex at end aneurysm surgery. Samples, collected hourly 4 11 days, analyzed immediately glucose, lactate, glycerol later pyruvate glutamate. The patients' was monitored constantly, daily recordings blood flow velocities performed using transcranial Doppler sonography.RESULTS: Concentrations measured substances varied widely. Individual analyses revealed uneventful clinical courses generally low stable levels different metabolites, those signs cerebral various patterns neurochemical changes. Lactate glutamate seemed sensitive markers impending ischemia, increased associated deficits. Obtaining data directly great advantage when relating values other findings.CONCLUSION: Bedside intracerebral monitoring delayed dramatic extracellular concentrations could correlated These findings emphasize potential neurosurgical intensive care (Less)